tbuckley/cabot-search huggingface dataset:
AB0191 OSTEOPOROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS: IMPACT ON BIOLOGIC DRUGS TOLERANCE AND SURVIVAL
Authors: S. Boussaid, K. Saadaoui, M. Hassayoun, S. Jemmali, S. Rahmouni, S. Rekik, H. Sahli, M. Elleuch
Journal: Annals of the Rheumatic Diseases (2022)

Background Osteoporosis is one of the main comorbidity of RA and leads to an increased risk for fragility fractures, which further impair functional ability, quality of life, and life expectancy. The influence of this condition on the maintenance and survival of biotherapies has rarely been studied. Objectives To assess the influence of osteoporosis on efficacy, tolerance, and biologic drugs survival. Methods We conducted a cross-sectional and observational study. Files of patients with RA on biologics drugs (archived from the files of patients on the National Health Insurance Fund of Tunis) were studied. Epidemiological characteristics such as age, sex, and comorbidities, were collected. All patients had a bone mineral density measurement. The patients were divided into two groups (a group with G1 osteoporosis and a group without osteoporosis G2). The therapeutic maintenance rate at 12, 24, 36, and 48 months as well as the biologic survival were analyzed using Kaplan-Meier survival curves and compared using the Log-Rank test. Results Three hundred and seventy-four files were selected. The average age of our cohort was 55±12.54 years [20-90]. A female predominance was noted with a sex ratio M/F=0.147. The average duration of RA was 11.7±6.76 years [2-41]. Osteoporosis was observed in 78 patients (20.9%). First biogics prescription was: tocilizumab 6% and rituximab 7%, etanercept 54%, adalimumab 14%, certolizumab pegol 13%, infliximab 6%.The maintenance of the first biotherapy was 40.53 [35.64-45.43] in G1 and 41.44 [39.01-43.86] in G2. The biologic survival curve study did not find any significant difference between the two group p= 0.598. The presence of osteoporosis would increase the risk of stopping biotherapy without being a statistically significant factor (HR = 1.109, p = 0.602) The therapeutic maintenance of the 1st biotherapy, in the presence of osteoporosis, was on average 40.53 months [35.64-45.43]. Conclusion Osteoporosis has not hitherto been retained as a determining factor in therapeutic maintenance (1), as was indeed the case in our study. Nevertheless, screening and early management of osteoporosis are necessary since it alone constitutes a risk factor for mortality. References [1]Leon L, Rodriguez-Rodriguez L, Rosales Z, Gomez A, Lamas JR, Pato E, et al. Long-term drug survival of biological agents in patients with rheumatoid arthritis in clinical practice. Scand J Rheumatol. 2016;45(6):456-60. Disclosure of Interests None declared
AB0870 ASSESSMENT OF FRACTURE RISK IN PATIENTS WITH NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS
Authors: H. Ferjani, O. Boudrigua, W. Triki, D. Ben Nessib, K. Maatallah, D. Kaffel, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2022)

Background Spondyloarthritis (SpA) is a chronic inflammatory disease that predominantly affects the sacroiliac joints and the spine. Patients with SpA have an increased risk of osteoporosis and fracture resulting from a combination of inflammation and immobility. The non-radiographic form for SpA (nr-axSpA) has the same predictors factors of bone fragility however the real fracture risk is unknown in this phenotype. Objectives This study aims to investigate BMD and the Fracture Risk Assessment Tool (FRAX) in patients with nr-axSpA. Methods We conducted a retrospective study including 40 patients with nr-axSpA, according to the ASAS criteria. For the enrolled patient, we collected the clinical and biological data. We calculated the disease activity using the Bath Ankylosing Spondylitis disease activity (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS). Functional impairment was assessed by the Ankylosing Spondylitis Functional Index (BASFI). We measured the bone mineral density using the dual-energy X-ray absorptiometry (DXA) in the anteroposterior lumbar, lateral spine, and hip neck. The ten-year probability of major osteoporotic fracture was calculated using the Tunisian version of Fracture Risk Assessment Tool (FRAX). Results Twenty-seven women (67.5%) and thirteen men (32.5%) were enrolled. The mean age was 41.5 years (±11.2), and the mean disease duration was 3,1 years (±2.7). The mean BASDAI and ASDAS CRP was 4.7 ± 2.2 and 3.27 ± 1.29, respectively. The mean BASFI was 3.6 ± 2.5. According to World Health Organization (WHO) criteria, 45% of patients displayed osteopenia and 30% osteoporosis. The mean major osteoporotic fracture (MOF) score was 0,09 ± 0,25 [0-1,3]. The MOF was significantly associated with BMD (p=0.000). The variables associated with MOF were a high physician’s global assessment score, a high BASFI, and female gender, but without significant relation. However, no correlation was found between the MOF and the disease duration, the presence of peripheral arthritis or enthesitis, and the ASDAS. Conclusion In nr-axSpA, patients with low BMD had a higher calculated 10-year fracture risk. FRAX score is related to functional impairment and gender. Disease activity does not affect the probability of fracture. Disclosure of Interests None declared
AB0381 ULTRASONOGRAPHY TO PREDICT FLARE AFTER DISCONTINUATION OF BIOLOGICS IN PATIENTS WITH RHEUMATOID ARTHRITIS IN REMISSION
Authors: T. Ogura, A. Hirata, T. Kagtagiri, Y. Takakura, H. Kameda
Journal: Annals of the Rheumatic Diseases (2022)

Background Ultrasonography (US) has been suggested to be useful in predicting flare in patients with rheumatoid arthritis (RA) after discontinuation of biological disease-modifying antirheumatic drugs (bDMARDs). Objectives This study aimed to investigate whether US can predict flare after discontinuation of bDMARDs in RA patients who have achieved stringent remission criteria. Methods We prospectively enrolled RA patients who maintained a simplified disease activity index ≤ 3.3 and discontinued bDMARDs and measured clinical assessment and US every 2-3 months for 2 years. The US examination was performed on 40 joints using the semi-quantitative method of 0-3 on the Grey-scale (GS) and Power Doppler (PD), and the total values for each patient were used as the GS score and PD score. Joints graded as GS score ≥ 2 or PD score ≥ 1 were counted as US arthritis. In addition, tendons at 36 sites were counted with or without tendinitis/tenosynovitis to obtain a tendon score. Results Thirty-six patients were enrolled and two patients who dropped out early without flare were excluded from the comparative analyses. At baseline, the median GS score was 7, PD score was 0, US arthritis was 0, and tendon score was 0. The total PD score was 0 in 26 patients (72%) and it was 1 in 5 patients (14%). There were no significant differences in US findings between the relapse group (20 patients) and the non-relapse group (14 patients). Positive and negative predictive value for PD-positive findings (total PD score ≥1) were 60% and 42%, and for total PD score ≥2 were 60% and 41%, respectively. Conclusion The PD score in the US findings at the time of bDMARDs discontinuation was not predictive for future disease flare. Disclosure of Interests Takehisa Ogura Speakers bureau: AbbVie G.K, Ayako Hirata: None declared, Takaharu Kagtagiri: None declared, Yuto Takakura: None declared, Hideto Kameda Speakers bureau: AbbVie G.K., Asahi Kasei Pharma, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., Eli Lilly Japan K.K., Gilead Sciences, Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma, Novartis Pharma K.K., and Sanofi Pharma, Grant/research support from: AbbVie G.K., Asahi Kasei Pharma, Astellas Pharma Inc., Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd., Mitsubishi Tanabe Pharma, Novartis Pharma K.K., and Sanofi Pharma
AB1225 TUBERCULOUS SPONDYLODISCITIS: DIAGNOSTIC DELAY AND OUTCOMES
Authors: M. Mrabet, S. Boussaid, T. Abdelkefi, S. Rekik, S. Rahmouni, S. Jemmali, H. Ajlani, H. Sahli, M. Elleuch
Journal: Annals of the Rheumatic Diseases (2022)

Background Tuberculous spondylodiscitis (SPDT) is a serious clinical condition that must be treated promptly. Despite the actual availability of more effective diagnostic tools, early diagnosis of SPDT remains difficult and a high index of suspicion is needed due to the chronic nature of the disease and its insidious and variable clinical presentation. Objectives Our aim was to study the correlation between the diagnostic delay of SPDT and its outcomes. Methods We conduct a monocentric retrospective and descriptive study in a rheumatology department. Data were collected from observations of patients hospitalized in the past 20 years (2001-2021) who have been diagnosed with SPDT. An early diagnosis is defined by a diagnosis within the first six months versus a late diagnosis that is retained after 6 months of symptoms. Results Fifty-two cases of SPDT were collected (37F/15M). The mean age of the population was 55.21±17.79 years [19-91]. Late diagnosis was more common: 41 patients (78.8%) versus 11 patients (21.2%) diagnosed early. Complications were more frequent (61%) in patients diagnosed late, but with no statistically significant difference (p=0.1). Disease-related complications, such as spinal compression, spinal deformation and recurrence of the disease, was statistically higher (45.5%) in early diagnosed patients (p &lt; 0.001). Drug complications, such as disruption of liver balance, hyperuricemia and major intolerance to anti-tuberculosis, were more frequent (36.6%) in patients diagnosed late (p = 0). Conclusion Despite highly sensitive imaging techniques, the diagnosis of tuberculous spondylodiscitis is often late, which may lead to severe deformity and early or late neurological complications. Disclosure of Interests None declared
AB0200 COMPARISON OF TREATMENT AND DISEASE ACTIVITY OF BETWEEN EORA AND YORA PATIENTS IN A NATIONWIDE DATABASE OF RHEUMATOID ARTHRITIS IN JAPAN “NINJA”
Authors: T. Matsui, S. Tohma
Journal: Annals of the Rheumatic Diseases (2022)

Background Elderly-onset rheumatoid arthritis (EORA) has different characteristics from younger-onset RA (YORA), however, few reports have conducted large-scale and long-term comparisons of treatment and disease activity between EORA and YORA. Objectives To compare the changes in treatment and disease activity of between EORA and YORA patients and to examine the characteristics of patients who achieved remission between them using data of a real-world database in Japan. Methods Analysis was performed using data from 2010, 2013, 2016, and 2019 of the National Database of Rheumatic Diseases in Japan (NinJa). Patients were grouped according to age of disease onset into G1: &lt;65 years (divided into G1a &lt;65 years and G1b ≧65 years by the age at analysis), G2: 65-74 years, and G3:≧75 years. Results MTX usage rate decreased over time in G2 (58.3% in 2013→55.1% in 2016→54.4% in 2019) and G3 group (41.1→39.5→37.9%). Biologics/JAKi usage rate increased (G1b:24.4→28.2→ 33.3%, G2:19.1→20.3→23.7%, G3:12.3→14.5→19.1%) and steroid usage rate decreased (G1b:49.1→41.8→35.1%, G2:42.2→36.8→29.5%, G3:50.9→45.9→39.2%) in all groups. TNFi usage rate decreased (G1b:19.5→18.0→17.3%, G2:15.4→ 14.1→12.7%, G3:6.2→4.3→5.1%) but IL-6i usage rate increased (G1b:5.2→7.4→9.5%, G2:4.1→4.3→5.9%, G3:2.7→3.4→3.3%) except for the G3 group. CTLA-4Ig usage rate also increased (G1b:3.7→5.3→6.7%, G2:2.7→5.5→5.9%, G3:3.6→6.5→8.1%) in all groups. The SDAI remission rate was increased over time in all groups (G1a:34.4→41.2→44.6%, G1b:25.1→31.4→35.2%, G2:33.1→37.1→42.2%, G3:30.0→35.9→39.3%) and EORA showed similar rate of remission with YORA. In the analysis stratified by SDAI using NinJa 2019, the positive rate of RF and ACPA decreased (ex RF. G3: 71.0→64.5→53.2%, ACPA. G3: 66.4→56.2→46.5%) and the proportion of male increased (ex G3: 23.0→30.3→35.1%) as the disease activity decreased (moderate / high → low → remission) in all groups. Also, the proportion of patients using two or more DMARDs decreased (ex G3: 43.8→35.2→22.4%) and the usage rate of steroid decreased (ex G3:52.5→37.9→30.2%). Furthermore, in a comparison of remission patients in each group, MTX usage rate (G1b:62.9→G2:61.7→G3:40.9%) and biologics/JAKi usage rate decreased (32.5→23.6→15.3%) as the age of onset increased, but the steroid usage rate increased (20.3→20.6→30.2%). Conclusion Disease activity improved over time, regardless of age of onset. EORA showed the same remission achievement rate as YORA, but the treatment content of those who achieved remission differed greatly depending on the age of onset. Disclosure of Interests Toshihiro Matsui Speakers bureau: Abbvie, Asahi Kasei, Ono, Chugai, Eli lilly, Pfizer, Grant/research support from: Abbvie, Asahi Kasei, Chugai, Shigeto Tohma: None declared
AB0746 Malignancy in Dermatomyositis
Authors: I. Naceur, I. Arbaoui, T. Ben Achour, M. Khanfir, I. Ben Ghorbel, M. Lamloum, F. Said, M. H. Houman
Journal: Annals of the Rheumatic Diseases (2022)

Background Link between dermatomyositis (DM) and malignancy is well established. Compared with general population, the incidence of cancer is estimated to be 5 to 7 times higher in patients with DM. However, criteria suggestive of associated malignancy still lack. Objectives The aim of our study was to describe clinical, biological, therapeutic features and outcomes of DM associated with malignancy. Methods We conducted a retrospective study of patients with DM diagnosed in an internal medicine department over a period time of 12 years. Cases of DM associated with malignancy were retained. Results Among 38 patients diagnosed with DM, malignancy was found in 10 (26.3%). Sex-ratio M/F was 0.3. The mean age at DM diagnosis was 40,22 years (range: 30-75 years) and the mean age at malignancy diagnosis was 43,19. In five cases the diagnosis of neoplasia was concomitant to the DM diagnosis. In the other 5 cases, the diagnosis of DM preceeded the neoplasia with a mean delay of 26 months [9-82 months]. The main clinical manifestations were: Gottron’s papules (n=8), skin ulcers (n=7), periungual erythema (n=7), erythredema of the face with orbital rim (n=5), impaired general condition (n=4),Raynaud’s with mega capillaries (n=2), skin necrosis(n=1) and subcutaneous calcinosis(n=1)., Muscular damage was found in 7 patients. Signs of severity such as swallowing disorders and false deglutition routes were found in 4 patients. Biological data showed acceleration of erythrocyte sedimentation rate (ESR) (n=4) and elevated muscle enzymes (n=7). Immunological features showed positivity of anti-Mi-2 antibodies in two cases, anti-transcription intermediary factor 1-gamma (TIF1- γ ) antibodies in one case, simultaneous positivity of anti Jo1 and anti SRP in one other case. Associated cancers were: Breast cancer (n=5),Colon carcinoma (n=2), Lung cancer(n=1), Cancer of the cervix(n=1) and T-cell lymphoma(n=1). In addition to specific oncological treatment, all patients received high doses of corticosteroids. It was associated with methotrexate in 4 cases. Two patients received intravenous immunoglobulin. A relapse was observed in 4 cases although a durable remission of associated neoplasia. Outcomes were fatal in 3 cases due to the underlying cancer. Three patients were lost to follow-up. Conclusion In our series, breast neoplasm was the most frequent cancer associated with DM. Despite oncological treatment, DM can remain progressive. Disclosure of Interests None declared
Hypertension Diagnosis and Management in Africa Using Mobile Phones: A Scoping Review
Authors: Iyabosola B. Oronti, Ernesto Iadanza, Leandro Pecchia
Journal: IEEE Reviews in Biomedical Engineering (2022)

Target 3.4 of the third Sustainable Development Goal (SDG) of the United Nations (UN) General Assembly proposes to reduce premature mortality from non-communicable diseases (NCDs) by one-third. Epidemiological data presented by the World Health Organization (WHO) in 2016 show that out of a total of 57 million deaths worldwide, approximately 41 million deaths occurred due to NCDs, with 78% of such deaths occurring in low-and-middle-income countries (LMICs). The majority of investigations on NCDs agree that the leading risk factor for mortality worldwide is hypertension. Over 75% of the world's mobile phone subscriptions reside in LMICs, hence making the mobile phone particularly relevant to mHealth deployment in Africa. This study is aimed at determining the scope of the literature available on hypertension diagnosis and management in Africa, with particular emphasis on determining the feasibility, acceptability and effectiveness of interventions based on the use of mobile phones. The bulk of the evidence considered overwhelmingly shows that SMS technology is yet the most used medium for executing interventions in Africa. Consequently, the need to define novel and superior ways of providing effective and low-cost monitoring, diagnosis, and management of hypertension-related NCDs delivered through artificial intelligence and machine learning techniques is clear.
POS0982 ANTIBODIES TO TWO NOVEL PEPTIDES IN NEW ONSET AXIAL SPONDYLOARTHRITIS
Authors: P. Ruytinx, P. Vandormael, E. Luyten, A. S. De Craemer, F. Van den Bosch, D. Elewaut, V. Somers
Journal: Annals of the Rheumatic Diseases (2022)

Background Diagnosis of axial spondyloarthritis (axSpA) is challenging since clinical manifestations often overlap with other disorders and a specific laboratory test for diagnosis is lacking. Previously, we identified antibodies to 3 Hasselt University (UH)-axSpA peptides which could provide a novel tool for diagnosis of a subset of axSpA patients. Validation of antibody reactivity in plasma samples of early axSpA patients (disease duration &lt; 5 years) from the UH and the Leuven Spondyloarthritis (Biologics) Cohort ((Bio)SPAR) cohorts revealed antibody reactivity against at least one of these 3 peptide targets in 14.2% of early axSpA patients (22/155) 1 . Objectives We aim to validate the diagnostic potential of the antibodies to these 3 peptides in a third independent cohort of new onset axSpA patients and controls. Methods Using enzyme-linked immunosorbent assays (ELISA), presence of antibodies to the 3 peptides was determined in 188 serum samples of the Belgian Inflammatory Arthritis and Spondylitis (Be-Giant) cohort, 74 controls with nonspecific chronic low back pain (CLBP) and 112 age and gender-matched healthy controls from the UH cohort. Patients were classified as having axSpA according to the ASAS classification criteria and had a mean age of 32.7 years. We further investigated whether clinical and disease characteristics were correlated with antibody reactivity. Results The presence of antibodies against 2 of the 3 UH-axSpA peptides was confirmed in the Be-Giant cohort. Antibody reactivity against 1 of the 2 UH-axSpA peptides was found in 11.2 % of newly diagnosed axSpA patients (21/188) compared to 3.6% (4/112, p=0.0290 ) in HC and 6.8% (5/74, p=0.3619 ) in CLBP. We did not detect a significant difference in age, sex, HLA–B27 status, enthesitis, symptom duration, treatment, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), BathAnkylosing Spondylitis Functional Index (BASFI), erythrocyte sedimentation rate (ESR), or C-reactive protein (CRP) levels between axSpA patients with and those without antibody reactivity against these 2 UH-axSpA peptides. Conclusion The presence of antibodies to 2 UH-axSpA peptides was confirmed in an independent cohort of newly diagnosed axSpA patients and could be of added value for discriminating axSpA patients from HC in the Be-Giant cohort. References [1]Quaden D, Vandormael P, Ruytinx P, Geusens P, Corten K, Vanhoof J, et al. Antibodies against three novel peptides in early axial spondyloarthritis patients from two independent cohorts. Arthritis &amp; rheumatology (Hoboken, NJ). 2020. Disclosure of Interests None declared
Author Correction: Single-nucleus chromatin accessibility profiling highlights regulatory mechanisms of coronary artery disease risk
Authors: Adam W. Turner, Shengen Shawn Hu, Jose Verdezoto Mosquera, Wei Feng Ma, Chani J. Hodonsky, Doris Wong, Gaëlle Auguste, Yipei Song, Katia Sol-Church, Emily Farber, Soumya Kundu, Anshul Kundaje, Nicolas G. Lopez, Lijiang Ma, Saikat Kumar B. Ghosh, Suna Onengut-Gumuscu, Euan A. Ashley, Thomas Quertermous, Aloke V. Finn, Nicholas J. Leeper, Jason C. Kovacic, Johan L. M. Björkegren, Chongzhi Zang, Clint L. Miller
Journal: Nature Genetics (2022)
AB1517 SYNOVITIS COMPLICATING THE COURSE OF COMMON VARIABLE IMMUNODEFICIENCY: CAUSAL OR COINCIDENTAL?
Authors: M. Yasmine, S. Miladi, A. Fazaa, H. Bousaa, L. Souebni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2022)

Background Common variable immunodeficiency (CVID) is a heterogeneous disorder characterized by hypogammaglobulinemia and an increased susceptibility to recurrent bacterial infections. Even though several immunological defects are involved in the pathogenesis of CVID, the genetic background of the disease remains unidentified [1]. Autoimmunity in CVID is not restricted to hematologic cells, as rheumatologic complications occur in perhaps 10% of patients, with females being more affected [1]. Objectives Here by we report a case of a CVID complicated with RF negative synovitis. Methods We report a case of a 36-year-old woman who was referred to our department for oligoarthritis. She had a history of primary immune deficiency revealed at the age of 30 with recurrent pulmonary infections. The disease was complicated with type 1 diabetes and bronchiectasis and was treated with annual infusion of immunoglobulin. The patient presented with pain and swelling in both knees evolving for two months. On physical examination, she had synovitis in both knees. Laboratory investigations revealed normal blood count with elevated C-reactive protein (CRP) and erythrocyte sedimentation rate: 36.2mg/l, and 32 mm/h respectively. Synovial fluid aspiration analysis of the knee revealed an inflammatory liquid without crystals. Bacterial culture was negative. Her serum was negative for Rheumatoid Factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibody and antinuclear Antibodies (ANA). Knee ultrasound revealed synovitis in both knees with Doppler signal. The Magnetic resonance imaging (MRI) of the knees showed active synovitis without any erosion. Ophthalmological assessment showed severe dry eye syndrome. As Sjögren’s syndrome was suspected, we performed a salivary gland biopsy that was normal. Results The patient did not fulfill criteria for auto-immune rheumatic related disease. She was treated with intraarticular glucocorticoids injections, with complete resolution of symptoms and disappearance of effusion on ultrasound. A follow-up was scheduled after one month. The synovitis has been attributed to rheumatologic involvement in the context of immune deficiency. Conclusion We report a rare case of RF negative synovitis complicating the course of CVID. Even though the symptoms could be mild compared to a typical RF+RA, it is important to educate clinicians as to the importance of maintaining a high index of suspicion about this rare, yet potentially treatable disease. Future research is indicated to understand the etiopathogenesis of rheumatologic manifestations in CVID. References [1]Yazdani R, Habibi S, Sharifi L, Azizi G, Abolhassani H, Olbrich P et al. Common Variable Immunodeficiency: Epidemiology, Pathogenesis, Clinical Manifestations, Diagnosis, Classification, and Management. J Investig Allergol Clin Immunol . 2020;30(1):14-34. Disclosure of Interests None declared